PET in epilepsy

Abstract

The major drawback in clinical PET imaging is that of specifi city: In epilepsy, PET shows both the cause and consequence of seizure activity in the focus and projection area of the seizure onset. This can make treatment decisions for resective surgery diffi cult. [ 18 F]FDG PET has been long integrated in presurgical neuroimaging in many centres and proved to be clinically useful in identifying focal glucose metabolic abnormalities. [ 1l C]Flumazenil, which delineates ã-aminobutyric acid receptor A (GABA-A) availability, may provide a biochemical marker of epileptogenicity and strengthens the hypothesis that inhibitory mechanisms are disturbed in the epileptic focus. Although [ 1l C]fl umazenil, and other novel PET ligands for opioid and serotonin neurotransmission, showed great potential in selected patient subgroups, these tracers have not yet reached the stage of routine clinical application.